GOVERNOR’S CONSORTIUM ON HISPANIC AFFAIRS …...when surveying the Hispanic community, due to increasing numbers of immigrants from Mexico. (The Office of Immigration Statistics

GOVERNOR’S CONSORTIUM ON HISPANIC AFFAIRS SUPPLEMENTAL REPORT:

A NEEDS ASSESSMENT OF DELAWARE HISPANICS

By: Nicole Ruggiano, Ph.D., M.S.W.

Center for Community Research and Service University of Delaware

October, 2008

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TABLE OF CONTENTS

LIST OF TABLES .......................................................................................................... 4 LIST OF FIGURES ......................................................................................................... 4 LIST OF BOXES ............................................................................................................ 4 Chapter 1: The Hispanic Population in Delaware ........................................................... 5

Introduction ......................................................................................................... 5 Methodological Issues of the Data ...................................................................... 6 About this Report ................................................................................................ 7 Demographics of the Hispanic Population in Delaware ..................................... 8

Families in the Hispanic Community ........................................................ 9 Key Findings from the Hispanic Community Assessment ............................... 10

Economic Findings .................................................................................. 10 Education Findings .................................................................................. 10 Health Findings ........................................................................................ 11

The Interrelationship between Economic Status, Education, and Health ......... 11 Chapter 2: Economic Status of Hispanics in Delaware ................................................ 13

What Does the Delaware Hispanic Needs Assessment (DHNA) Tells Us? ..... 13 The Current Economic Status of Delaware Hispanics ...................................... 13

How do Delaware Hispanics Compare to Other Groups in Economic Status? .......................................................................................... 13

The Economic Status of Hispanic Families in Delaware ......................... 13 The Economic Status of Middle Aged and Older Hispanics ................... 14 The Economic Status of Delaware Hispanics across County Lines ........ 15

Where are Delaware Hispanic Workers Employed? ......................................... 16 The Status of Low-Income Hispanics in Delaware ........................................... 17 Barriers to Economic Advancement ................................................................. 19

Language as an Economic Barrier ........................................................... 19 Inability to Access Information on the Internet as a Barrier .................... 21 Transportation as an Economic Barrier ................................................... 22

Conclusions on Economic Status ...................................................................... 23 Chapter 3: Delaware Hispanics and Education ............................................................. 24

What Does the Delaware Hispanic Needs Assessment (DHNA) Tell Us? ....... 24 Key Issues Related to Education in the Hispanic Community .......................... 24

Hispanic Adults in Delaware and Education ........................................... 24 The Status of Delaware Hispanics without a High School Diploma ....... 25 Hispanic Youth and Education ................................................................ 26

Barriers to Education ........................................................................................ 29 Language as a Barrier to Education ......................................................... 29 Poverty as a Barrier to Education ............................................................ 30 Limited Parental Involvement as a Barrier to Educational ...................... 31 Lack of Support and Discrimination as Barriers to Education ................ 32

Comparing Educational Attainment of Hispanic Adults Across County Lines 33 Conclusions on Education................................................................................. 34

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Chapter 4: Delaware Hispanics and Health .................................................................. 36 What Does the Delaware Hispanic Needs Assessment (DHNA) Tell Us? ....... 36 The Health Status of Hispanics ......................................................................... 36

Generational Health Trends in the Hispanic Community ........................ 37 Hispanic Health Issues across County Lines ........................................... 38

Barriers to Health .............................................................................................. 38 Lack of Health Insurance as a Barrier to Health ...................................... 38 Limited Access to Needed Health Care Services as a Barrier to Health . 39 Language as a Barrier to Health ............................................................... 41 Discrimination as a Barrier to Health ...................................................... 43

Conclusions on Health ...................................................................................... 43 Chapter 5: Policy Recommendations for the Delaware Hispanic Community ............. 46

Policy Recommendations for Addressing Issues within the Hispanic Community .............................................................................................. 47 Economic Status ...................................................................................... 47 Education ................................................................................................. 47 Health 48 Additional Research Efforts ..................................................................... 49

Appendix A: Methodological Suggestions for Future Statewide Surveys of Delaware Hispanics ........................................................................................................... 51

Demographic Data ................................................................................... 51 Economic Data ......................................................................................... 51 Educational Data ...................................................................................... 52 Health Data .............................................................................................. 52

References ..................................................................................................................... 53

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LIST OF TABLES

Table 1. Demographical summary of B & A survey respondents ................................... 8

Table 2. Comparison of Economic Characteristics, All Races and Hispanic/Latinos, U.S. and Delaware Data. .......................................................................... 15

Table 3. A Comparison of Education Attainment of Adults Ages 25 and Older, All Races and Hispanics/Latinos, U.S. and Delaware ................................... 25

Table 4. Number of Hispanic Students in Delaware Public and Nonpublic Schools, 1997-1998 and 2007-2008 School Year Comparisons ............................ 27

Table 5. Educational Attainment of English and Limited English Proficient Hispanics with Limited English Proficiency (LEP) in Delaware, According to the DHNA. ..................................................................................................... 29

Table 6. Health Comparisons between First, Second, and Third Generation Hispanic Immigrants ............................................................................................... 37

Table 7. Disparities in Health Care Quality, Comparison of Race/Ethnicity (2001 Health Care Quality Survey) .................................................................... 43

LIST OF FIGURES

Figure 1. The Interrelationship between Education, Economic Status, and Health Status, as Indicated through DHNA Data ............................................... 12

Figure 2. Occupations of Delaware Hispanics, with Comparisons of New Castle County Hispanics and Southern Delaware Hispanics ............................. 16

Figure 3. The Influence of Socioeconomic Status on Educational Values in Hispanic Families: Intergenerational Effects ......................................................... 32

LIST OF BOXES

Box 1. What is the Self-Sufficiency Standard?............................................................. 18

Box 2. What is Cultural Competency? ......................................................................... 47

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CHAPTER 1: THE HISPANIC POPULATION IN DELAWARE

Introduction Over the last few decades, the United States has experienced a significant increase in the Hispanic population through both immigration and growth in young immigrant families. Today, the richness of the Latin culture and the growth of this population are visible in many aspects of life from the arts and entertainment to foods and the media. Delaware has been similar to the overall United States in that it has experienced a proliferation in its Hispanic community. Although Delaware’s Hispanic population is somewhat small (comprising 6.5 percent of the population in 2007 compared to 15.1 percent of the U.S. population), the growth rate of this population was considerably faster than the nation overall (50.1% versus 28.8%) between 2000 and 2007 (U.S. Census, 2007). As a result of becoming the fastest growing population in Delaware, the Hispanic community requires increasing attention, particularly from federal, state, and local governments, to further understand its characteristics and needs. In order to identify and address the needs of Hispanic Delawareans, Governor Ruth Ann Minner established the Governor’s Consortium on Hispanic Affairs in 2007. The Consortium began its work in 2007 by contracting with Bendixen & Associates (hereinafter referred to as B&A), an international research firm known for its multilingual capabilities, to conduct the comprehensive Delaware Hispanic Needs Assessment (DHNA). From November 2007 to February 2008, data on the Hispanic community were collected using a triangulation of methods1

• Phase 1: Three focus group interviews (one in English in New Castle County, another in Spanish in New Castle County, and another one in Spanish in Sussex County) with Hispanic community members;

that included:

• Phase 2: Fifty interviews with leaders (nonprofit, for-profit, and public) in the Delaware community; and

• Phase 3: A statewide (telephone and face-to-face) survey of 804 Hispanic adults currently living in Delaware.

1 For a detailed description of the methodology used by B&A, please refer to: Bendixen and Associates (2008). Report to the Governor’s Consortium on Hispanic Affairs: Delaware’s Hispanic needs assessment. Coral Gables, FL: Author. (Available at www.delcf.org )

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Methodological Issues of the Data As with most studies, there are methodological issues to consider when reviewing the study findings. In the case of the DHNA, these methodological issues are most notable in terms of the statewide telephone survey of Delaware Hispanics. Telephone surveying has become a common method in collecting quantitative data on various populations. However, methodological issues have been raised to the extent to which disadvantaged groups (e.g. low-income, minority, undocumented immigrants) are adequately represented in landline-telephone surveying methods (Blumberg, Luke & Cynamon, 2006; U.S. Census, 1994). These issues are especially pertinent when surveying the Hispanic community, due to increasing numbers of immigrants from Mexico. (The Office of Immigration Statistics (Hoefer, Rytina & Campbell, 2007) reports that in 2006 more than half (56.9) of the estimated 11.5 million undocumented immigrants in the United States were from Mexico.) In order to better reach minority groups through telephone surveys, the DHNA utilized survey techniques that would increase their likelihood of developing a representative sample of Delaware Hispanics. First, they used an ethnic “encoding system” that creates a sample of telephone listings of individuals who are identified as being Hispanic by their first and last names. This ethnic encoding system is more efficient at creating a sample of Hispanics compared to drawing a sample from all telephone listings and has been utilized in other academic studies on ethnic minorities (Wilson, Chen, Grumbach, Wang & Fernandez, 2005). The overwhelming majority (N = 750, or 93.3%) of surveys were conducted via traditional telephone methods. However, B&A also supplemented the telephone surveys with face-to-face interviews, which have been used in research to create more representative samples of the undocumented Hispanic population (Amuendo-Dorantes & Mundra, 2007; Corona, Gonzalez, Cohen, Edwards & Torey, 2006; Schur, Berk, Good & Gardner, 1999). These surveys were conducted door-to-door and in areas where large Hispanic populations could be found (restaurants, work sites, churches, etc.). B&A has assured that although this small sample (N=54) of survey respondents were obtained through such convenience sampling methods and the data collected from the survey has been cross-referenced to U.S. Census data. The DHNA reported an overall sampling error for the sample of 804 as ±3.5 percent at the 95 percent level of confidence. If the survey was repeated an infinite number of times using the same methodology, 95 percent of the time, we would expect the results to fall within ±3.5 percent of the DHNA results reported. By having a sample that is more inclusive of the undocumented population, it is possible that the validity of survey results is improved. However, it also explains why some of the data presented through B&A findings is different than those provided by other surveys, which did not use the methods presented here. It is also important to note, though, that the B&A survey consisted of some questions that may be viewed as sensitive to immigrant and/or undocumented populations. Some survey questions that had larger refusal rates or missing responses than others include:

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• Thinking about the next few years, do you plan to remain in Delaware or do you plan to leave the state? (Refusal rate/Missing Responses: 13%)

• How would you describe the way the Police in Delaware treats you and your family – friendly or unfriendly? (Refusal rate/Missing responses: 15%)

• Are you a citizen of the United States? (Refusal rate/Missing responses: 21.7%) Of course, as the number of respondents decreases, there is an increased risk of error in any statistical analysis performed. Within this report, statistical methods were used in order to assess the relationships between variables, with the most frequently used statistical test being chi-square. In cases where a statistical relationship has been demonstrated for two variables, readers will find a footnote that indicates the size of chi-square (x2), the level of significance, and the number of survey respondents who were included in the individual analysis (N). In other words, those who did not respond to a particular question were not included in the analysis, which makes the overall size of the sample (N) smaller.

About this Report After reviewing the original B&A report, the Governor’s Consortium on Hispanic Affairs has expressed interest in further exploring three central topics from the research findings from the original research report: 1) the economic status of Hispanics in Delaware; 2) Delaware Hispanics and education; and 3) the health status of Hispanics in Delaware. To complete this in-depth assessment, data from the DHNA were reviewed and re-analyzed. Some examples of this current analysis include a comparison of variables that were not compared in the original report and further examination of sub-populations of Hispanics (i.e. low-income, mostly/only Spanish speaking, etc.). Readers will find discussions of these sub-populations within the exploration of the three central topics described above. In most cases, quantitative data from the B&A survey are initially presented, followed by supporting evidence from the qualitative data derived from focus groups and interviews, as well as findings from other studies on Hispanic communities. In addition to the DHNA data, this report is derived from a variety of data sources, including the U.S. Census Bureau, and related academic literature. Throughout the report, you will find comparisons between New Castle County and Southern Delaware. The B&A survey sample did not identify many Hispanics living in Kent County, with respondents from Kent County only making up 8.2 percent of the overall survey sample. Being such a small group, the data from Kent County Hispanics in the survey cannot be generalized to all Hispanics living in the county. However, by combining Kent County respondents with those from Sussex, which made up a larger proportion of the sample (26%), the community assessment was able to compare the experiences of New Castle County Hispanics with those living in Southern Delaware. Those who are interested in comparing New Castle County Hispanics with those in Southern Delaware, please refer to the boxed sections titled Across County Lines…A Comparison of Delaware Hispanics. These sections can be found within each of the larger topical sections.

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Demographics of the Hispanic Population in Delaware Overall, the information gathered by the DHNA provides descriptive detail on the demographics of the Hispanic community. Table 1 provides a summary of these demographics. Interestingly, the findings from the survey indicate that a large proportion of the Hispanic community is made up of young families. For instance, 533 (66.5%) of survey respondent reported that they were between the ages of 18-39, with 67.5 percent of these respondents also indicating that they have at least one child under the age of 18 living in the home. Also, the study found that Delaware’s Hispanic community is comprised of individuals and families from a variety of backgrounds. Most report that they are foreign born, with the half (47.3%) indicating that they are from Mexico, 15 percent are from Central America and smaller populations from South America (6.6%), the Dominican Republic (4.9%), and Cuba (1.0%). Along with immigrants, nine percent report that they were born in the United States and 14.5 percent stating that they are from Puerto Rico. When examining where Hispanics live across the state, we find that the majority live in New Castle County (65.8%) and Sussex County (26.0%), with smaller Hispanic communities living in Kent County (8.2%).

Table 1. Demographical summary of B & A survey respondents

Age (N=804) Country of Origin (N=792) 18-29 Years 36.9% Mexico 47.3% 30-39 Years 29.6% Central America 15.0% 40-49 Years 16.7% Puerto Rico 14.5% 50-64 Years 11.3% United States 9.0% 65 Years and Older 5.5% South America 6.6%

Gender (N=804) Dominican Republic 4.9% Male 49.9% Cuba 1.0% Female 50.1% Other 1.6%

Have Children Living in the Household (N=802)

Employment Status (N=804)

Yes 58.6% Employed 65.9% No 41.4% Unemployed 34.1%

Annual Household Income (N=687) English Proficiency (N=802) < $20,000 44.4% Only Speaks Spanish 33.0% $20,000 - $30,000 28.8% Mostly Speaks Spanish 22.6% $30,000 - $50,000 13.0% Speaks Both Eng. and Spanish 39.5% $50,000 - $75,000 7.3% Mostly Speaks English 3.1% > $75,000 6.6% Only Speaks English 0.5%

County Respondent Resides In (N=804) Educational Attainment (N=795) New Castle 65.8% Less than High School 38.6% Kent 8.2% High School 33.7% Sussex 26.0% Some College/Tech School 18.7%

Four-Year College Degree 5.5% *Percentages may not add up to 100% due to rounding.

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The DHNA (Phase 1 and 2) findings indicate that the Hispanic community in Delaware is one that values family and hard work. However, numerous disparities that Hispanics experience in relationship to their economic status, educational attainment, and health were also identified. Although there are programs and services within the state related to these needs, there are many barriers that the Hispanic community experiences in accessing information and services. Some of these barriers include:

• The majority (55.6%) speak only or mostly Spanish.

• Almost three-quarters live in households with annual incomes of less than $30,000, with 44.4 percent reporting that they live in households with incomes below $20,000 per year.

• Many adults (38.8%) do not have a high school diploma.

• A large percentage (44% in New Castle County and 54% in Sussex County) of Hispanic Delawareans has no health insurance.

Families in the Hispanic Community As previously indicated, 66.5 percent of DHNA survey respondents ages 18 through 39 reported that they had at least one child under the age of 18 living in their household. For the entire sample (including 802 adult respondents), 58.6% reported living in households with at least one child under age 18. According to the U.S. Census, in 2007 there were more than 21,000 of Hispanic children under the age of 18 living within the state, making up 10.4 percent of the entire youth population. While the study did not directly examine Hispanic children in Delaware, information about households with children in the DHNA provides some insight on the current status of the youngest Hispanics in the state of Delaware. Some of the characteristics of adult respondents with children living in the household include:

• Around two-thirds (66.2%) live in New Castle County.

• Over 45 percent (45.7%) have household incomes of less than $20,000 per year.

• About a third (32.8%) are unemployed.

• More than half (54.8%) are not proficient in English.

• Over 57 percent (57.4%) have a driver’s license.

• Thirty-seven percent do not have a high school diploma.

• Over 56 percent do not have access to health insurance.

• Only about one in five (19.3%) are U.S. citizens.

While demographic data on the Hispanic community is helpful in developing a needs assessment, the Consortium has further analyzed data on the Hispanic community to identify specific issues and challenges that this population is experiencing, particularly in the areas of economic status, education, and health. The following presents key findings from this analysis.

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Key Findings from the Hispanic Community Assessment

Economic Findings Findings from the DHNA indicate that Hispanics in Delaware experience significant economic disparities when compared to the overall population. Hispanics are more likely to: be unemployed, have household incomes at or below the poverty threshold, have lower median incomes, and are more likely to receive food stamps. These disparities many times fuel the stereotypes and negativity that the general public holds toward this population. However, key findings from the DHNA indicate that many of these disparities are related to economic and educational barriers that Hispanics experience. Some of the specific findings from the report include:

• About a third of Hispanic adults are unemployed.

• When comparing survey respondents’ incomes with the Delaware self-sufficiency income standard we find that at least 56.9% of Hispanic households in New Castle County and 58.9% in Southern Delaware do not earn enough money to meet their family’s basic needs.

• Using the same income standard, it was found that at least 88.4% of non-English speaking Hispanic households in New Castle County and 93.8% of those in Southern Delaware do not earn enough money to meet their family’s basic needs.

• Delaware Hispanics may find language to be a significant barrier to achieving an economically stable life.

• Study findings suggest that discrimination and language barriers are resulting in significant wage gaps.

Education Findings While education plays an important role in one’s ability to succeed in life, the Hispanic community experiences significant disparities in educational attainment. Some of the specific findings from the consortium’s assessment include:

• Two-fifths of Hispanic adults indicate that they have less than a high school diploma.

• Hispanics without a high school diploma experience economic hardships, such as low-incomes. Many do not have health insurance. Often, they lack English language skills and they experience barriers to citizenship.

• Adult Hispanics are interested in taking English courses, but experience barriers to attending classes.

• When examining issues of youth education, parental involvement and parents’ ability to speak English have been identified as factors in children’s educational success.

• Hispanic race, low-income status, and limited English proficiency are all identified as factors attributing to low state testing scores.

• The economic hardships that Hispanic families experience are a factor of high school dropout of Hispanic youth.

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• Cultural competency in the education system may be attributing to elevated drop out rates and inability to engage with Hispanic students.

Health Findings Along with economic status and education, the Consortium examined the health status of the Hispanic community. Utilizing a combination of national and state health statistics data along with findings from the DHNA, it was found that Hispanics experience significant barriers to accessing high-quality health care that may create major health disparities. Some of the key findings concerning health in the Hispanic community include:

• Many Hispanics are without health insurance.

• More than a quarter of uninsured Hispanics do not regularly see a medical professional for preventative care.

• Poverty, education, transportation, and lack of English proficiency are all factors in Hispanics’ inability to access health care services.

• Hispanics experience disparities related to specific diseases, such as increased rates of diabetes, obesity, cervical cancer, and HIV/AIDS.

• With each generation, the Hispanic community is becoming less healthy in terms of diabetes, high blood pressure, mental health, and asthma.

The Interrelationship between Economic Status, Education, and Health This supplemental report on the Hispanic community in Delaware organizes the key issue topics of economic status, education, and health into separate chapters. While each of these key issue areas present unique concerns for Delaware Hispanics, the data from the DHNA indicate that these three key issue areas are also interrelated (see Figure 1). For instance, the DHNA suggests that low household income may create barriers to success in education and access to needed health care services. The DHNA also indicates that inability to speak English and/or a lack of a high school diploma may create barriers to obtaining living wage jobs and access to needed health care services. One of the most important implications of the interrelationship between economic status, education, and health status is that there needs to be a holistic approach to addressing key issues within the Hispanic community. For example, to address language barriers within the Hispanic community, an innovative education program may be implemented for Hispanic adults. While the program may be well-designed in its approach to teaching English, it may fail to engage Hispanics with limited English proficiency if the classes and supplies are too costly or if the program does not offer flexibility to accommodate individuals’ work schedules. Hence, special consideration should be given to how all of the key issues affect the lives of Delaware Hispanics, so that programs and services can better reach those in the community.

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Figure 1. The Interrelationship between Education, Economic Status, and Health Status, as Indicated through DHNA Data

Inability to speak English or low

educational attainment may create barriers to accessing needed health care

services.

Inability to speak English or lack of a high school diploma may create barriers to economic opportunities.

Similarly, lack of financial resources may create barriers to learning

English or succeeding in school

Lack of financial resources may create barriers to accessing needed health care

services.

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CHAPTER 2: ECONOMIC STATUS OF HISPANICS IN DELAWARE

What Does the Delaware Hispanic Needs Assessment (DHNA) Tells Us? According to the DHNA conducted by Bendixen & Associates, many Hispanics in Delaware are experiencing significant economic hardships. For instance, 34.1 percent of Hispanic adults surveyed through the DHNA reported that they were unemployed and 44.4 percent of Hispanic adults who reported their household income (N=687) stated that it was less than $20,000. Considering these troubling statistics, the Governor’s Consortium on Hispanic Affairs wanted to learn more about the economic status of Delaware Hispanics, particularly in relationship to: 1.) how Delaware Hispanics are fairing economically in comparison to the overall state; 2.) the economic characteristics of sub-populations of Hispanics in Delaware, such as Hispanic families, older Hispanics, and low-income Hispanics; 3.) how the economic status of Hispanic compares across counties; and 4.) barriers that low-income Hispanics may be experiencing when trying to obtain economic stability. To learn more about these issues, the Consortium further analyzed data from the DHNA and examined current research from academic, nonprofit, and government sources. The following presents the findings from these activities.

The Current Economic Status of Delaware Hispanics

How do Delaware Hispanics Compare to Other Groups in Economic Status? As home foreclosures, unemployment, and gas prices continue to rise, many American families continue to experience moderate to significant hardships. While the negative effects of the slowing economy are experienced across the United States, Delawareans typically have experienced a higher level of economic status when compared to the overall population. For example, compared to the nation as a whole, Delaware residents have a higher median income, they are less likely to be living below the poverty threshold, and are half as likely to be receiving Food Stamps (see Table 2). However, when aggregating demographic data by race, it is unfortunate to find that Hispanic families in Delaware are economically fairing worse than the overall Delaware population. Another troubling fact is that by some economic standards, Hispanics in Delaware are fairing worse economically when compared to the overall population of Hispanics in the United States (U.S. Census Bureau, 2006). Although Hispanics in Delaware are more likely than Hispanics nationwide to have household incomes greater than $75,000, they are also more likely to have Household incomes below $25,000 (suggesting that there is a smaller Hispanic middle class in Delaware compared to the overall nation). In addition, when compared to Hispanics nationwide, Delaware Hispanics are more likely to be living below the federal poverty level, are less likely to have finished high school, and have a lower median income level.

The Economic Status of Hispanic Families in Delaware Similar to U.S. Census data, findings from the DHNA indicate that Delaware Hispanics are experiencing considerable economic hardships. This is especially true for Hispanic households with children. When looking at survey respondents who have children in the home, we find:

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• More than half (55.3%) report that they do not earn enough money to support their family.2

• Almost three-fourths (73.0%) live in households with annual incomes of $30,000 or less; 40.9 percent have household incomes below $20,000.

• More than two-fifths (42.6%) do not have a driver’s license.

• Eighty-nine percent are interested in job training.

The Economic Status of Middle Aged and Older Hispanics Looking at the demographics of the DHNA sample, it is interesting to note that the age of respondents is not normally distributed, with the majority (67%) reporting their age as 39 or younger. While fewer respondents (16.8%) indicated that they were middle-aged and older, it is vital to understand the experiences of older Hispanics in Delaware so that Delaware can be prepared as this population ages. From the DHNA, it was found that (like their younger counterparts) middle-aged and older Hispanics are also experiencing economic hardships. For instance, 45.9 percent report living in households with annual incomes of less than $20,000, 52.6 percent are unemployed, and almost half (49.2%) rent their homes (which limits their ability to build equity).

These findings on older Hispanics are similar to findings from other studies, such as AARP’s 2008 report titled, The Economic Slowdown’s Impact on Middle-Aged and Older Hispanics. Through this study, it was found that 80 percent of Middle Aged and Older Hispanics are having a difficult time paying for critical items, such as food, gas, and medicine and 71 percent report having difficulty in paying for utilities, including heating, cooling, and phone service. In order to cope with economic stressors, almost a quarter (22%) report that they have to cut back on the medications that they take due to costs.

2 Survey respondents were asked the question “Do you feel as though you currently earn enough money to support yourself and your family?” Hence, responses are based on the respondent’s perception of their earnings and are not based on an analysis of their income.

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Table 2. Comparison of Economic Characteristics, All Races and Hispanic/Latinos, U.S. and Delaware Data.

Economic Characteristic

U.S. (All Races)

U.S. Hispanics

Delaware (All Races)

Delaware Hispanics

Household Income Level

<$15,000 14% 16.2% 10.6% 17.0%

$15,000 - $24,999 11% 15.0% 10.7% 18.2%

$25,000 - $34,999 11% 13.9% 9.9% 9.5%

$35,000 - $49,999 15% 17.0% 15.9% 16.5%

$50,000 - $74,999 19% 18.2% 19.9% 16.5%

>$75,000 15% 19.7% 33.0% 22.3%

Percentage of adults ages 25 and Older With Less Than a High School Diploma

15.9% 39.8% 14.5% 44.1%

Percentage Families Below Poverty Level

9.8% 19.3% 7.6% 24.5%

Median Income $58,526 $40,074 $48,451 $38,747

Percentage of Households Receiving Food Stamps

10.8% 13.3% 4.3% 12.6%

Source: U.S. Census Bureau, 2006

The Economic Status of Delaware Hispanics across County Lines One aspect of the Hispanic community that the Consortium was interested in examining is if there are differences between Hispanics living in New Castle County and those living in Southern Delaware (Kent and Sussex Counties). Using survey data collected through the DHNA, it was found that there are some differences, such as:

• Southern Delaware Hispanics are more likely than those from New Castle County to have household incomes less than $20,000.

• Hispanics who are undocumented citizens are significantly more likely to be living in Southern Delaware than New Castle County (77.9% versus 54.1%), which suggests that there may be more employment opportunities for undocumented workers in Sussex and Kent Counties.

• Those who indicated that they are day laborers are significantly more likely to be living in Southern Delaware (31.6% versus 13.4%).

The Consortium also found that there were many economic characteristics that were the same for Hispanics living across the state, including:

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• Hispanics with limited English proficiency are as likely to be living in New Castle

County as in Southern Delaware.

• When comparing respondents who indicated that they have a source of information for their family’s needs, Hispanics in New Castle County are similar to those down state.

• Respondents who indicated that they have a driver’s license are equally as likely to be living in New Castle County as Southern Delaware.

• Respondents from both areas are equally as likely to feel that they do not earn enough money to support their families.

By identifying county differences in the economic status of Delaware Hispanics, program and policy developers can better understand where needed services and programs should be located within the state.

Where are Delaware Hispanic Workers Employed? Respondents who indicated through the DHNA that they are currently employed (N=533) reported a variety of occupations (see Figure 2). The top three occupations held by Hispanics in Delaware are construction (21.1%), restaurant work (12.1%), and professional occupations (10.2%). These were also listed as the top three occupations for Hispanics in New Castle County.

0

5

10

15

20

25

30

35

Constructi

on

Day Labor

Domestic S

ervice

sHotel

Restauran

t

Agricultu

re

Administrat

ive

Professio

nal

Other*

Perc

ent

Delaware

NCCo

Lower DE

*The category “Other” is primarily composed of the response “Other,” along with a small proportion of respondents who responded with: Textile, Unemployed, Housewife, Student or Refused.

Figure 2. Occupations of Delaware Hispanics, with Comparisons of New Castle County Hispanics and Southern Delaware Hispanics

So. DE

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As indicated in Figure 2, many Hispanics work in industries that are known for low-wage work, such as restaurants, domestic services, agriculture, and hotels. However, the most popular occupation that Hispanics reported was construction, an industry that is usually associated with moderate to high wages. However, while the U.S. Bureau of Labor Statistics (2007) reports that the average salary for a construction worker is $43,320, more than three-fourths of Hispanic construction workers reported household incomes of $30,000 or less and more than a third having household incomes less than $20,000 per year. It is currently unclear if this difference in wages is due to the types of construction jobs that Hispanics hold, or if it is due to discrimination within the industry. Also interesting to note that in Southern Delaware, work as “day laborers” is the second most commonly (12.7%) reported occupation (after the most commonly held work in construction). Day laborers, unlike other occupations, are usually hired on a day-to-day basis and fulfill a variety of jobs in the construction and landscaping industries. Day laborers (or jornaleros) have posed unique concerns to public policy because they are frequently the target of discrimination groups and vigilante groups, who argue that they take good paying jobs from American workers and abuse government assistance. However, the DHNA found that most day laborers have low household incomes and they are not likely to go to the government for information on their families’ needs. In addition, some day laborers (almost eight percent) are U.S. citizens. While the sample of day laborers from the DHNA was small (N=39), these characteristics of day laborers are similar to those found in larger studies of this sub-population of Hispanics (Valenzuela, 2007).

The Status of Low-Income Hispanics in Delaware Similar to other studies of Hispanic populations, many Delaware Hispanics are low-income. In fact, 44.4 percent of the 687 DHNA respondents who indicated their household income level reported that it was less than $20,000 per year.3

3 Note that household income is different than individual income. Household income is the amount of income that all household members earn annually.

What is further troubling is that 55.5 percent of respondents in this income bracket also reported having children under the age of 18 living in their household. In order to assess the adequacy of a given income, the federal poverty threshold is often used as a guideline. However, for the purpose of this needs assessment, the self-sufficiency standard may be a more appropriate as a guideline for income adequacy. Unlike the poverty threshold, the self-sufficiency standard takes into account the income needed to cover necessary expenses, such as housing, health care needs, and transportation (see Box 1). Using Delaware’s self-sufficiency standard, we find that in New Castle County, a household with at least one adult and one young child would need a household income of at least $30,000 to be economically self-sufficient. However, when examining data from the DHNA, we find that 52.6 percent of Hispanic adults with at least one child living in the home report a household income of less than $20,000. Although in Southern Delaware the self-sufficiency standard is lower than that of New Castle County (at least $20,000), 58.9 percent of Hispanic adults in Southern Delaware with at least one child in the home reported household incomes of less than $20,000.

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This comparison of Hispanic household incomes to the self-sufficiency standard suggests that at least 56.9% of Hispanic households in New Castle County and 58.9% of Hispanic households in Southern Delaware do not earn enough money to meet their family’s basic needs.

The DHNA also indicates that self-sufficiency is more difficult to achieve when Hispanics do not speak fluent English. Using the same income and family guidelines as used above, the study found that at least 88.4% of Hispanics with limited English proficiency (LEP) in New Castle County and 93.8% of LEP Hispanics in Southern Delaware do not earn enough money to meet their family’s basic needs. Hence reiterating the importance of learning English to economic security. Given Hispanics’ low household incomes, it is not surprising to find that more than half (50.6%) of respondents report not having enough money to support their families. This proportion was similar in both New Castle County and Southern Delaware. It is also interesting to note that employment status does not have a large effect on respondents’ view of their economic status. In fact, almost half (49.1%) percent of employed respondents reported not earning enough money for their family’s needs, versus 57.8% of unemployed respondents.4

4 x2 = 5.14, p = 0.02, N = 783

Focusing on respondents in low-income households provides a unique picture of the most disadvantaged in the Hispanic community. When comparing respondents from low-income households (less than $20,000) with those in higher earning households, we find that these Hispanics are more likely:

Box 1. What Is the Self-Sufficiency Standard? The self-sufficiency standard is a measurement of income adequacy. Many critics of the federal poverty threshold believe that this measure is unrealistically low. In fact, the federal poverty threshold only takes into account the amount of money required to feed a family and disregards other necessary expenses that families endure. The self-sufficiency standard represents the amount of income required to live free of private (i.e. charity) or government assistance (i.e. TANF/welfare, food stamps, Medicaid, etc.) and takes into consideration necessary expenses that individuals and families would normally pay in order to meet their basic needs. The standard assumes that adult family members are working full-time and factors in costs incurred by maintaining employment, including: taxes, child care, regional cost of living, transportation, and housing. Also unlike the federal poverty threshold, the self-sufficiency standard takes into account the cost of living of the area being assessed. Hence, in Delaware, a family living in Trolley Square would need a greater income to be financially stable compared to a family living in Dover or Milford. The self-sufficiency standards for areas in Delaware were developed by Pearce & Brooks at the Wilmington Urban Metropolitan League in 2003.

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• to speak only or mostly Spanish;5

• to not have a driver’s license (30.5% have licenses versus 74.9%);

6

• to not have private or public health insurance;

7

• to not have a bank account.

and

8 Regardless of race, many families in today’s society who do not earn enough to support their families must turn to external sources (i.e. family, friends, charities, government aid, etc.) in order to meet their needs. This is especially true in the Hispanic community. When asked where they turn for information regarding issues affecting their families, the most popular answer was “family and friends.” Similarly, Hispanics without driver’s licenses are most likely to depend on family and friends for transportation. Although the study identified characteristics associated with low-income Hispanic households, it is unclear if these characteristics are attributing to low-income status, are result of their low-income status, or both. For instance, Hispanics in low-income households are less likely than those with higher household incomes to have a bank account, but it is unclear if low-incomes prevent Hispanics from obtaining a bank account, if not having a bank account creates a barrier to economic advancement, or both.

Barriers to Economic Advancement Although low-income Hispanics are just as likely as those with higher income to have interest in job training or English classes, information provided through the DHNA suggest that low-income Hispanics may be experiencing numerous barriers to economic opportunity, such as limited English proficiency, low-education attainment, and transportation. The following section presents further information on these barriers.

Language as an Economic Barrier When comparing Delaware Hispanics who speak only or mostly Spanish9

5 x2 = 78.02, p = 0.00, N = 802 6 x2 = 116.34, p = 0.00, N = 804 7 x2 = 47.45, p = 0.00, N = 798 8 x2 = 106.94, p = 0.00, N = 796 9 Within this report, the collective term for Hispanics who speak mostly Spanish and Hispanics who speak only Spanish will be referred to as Hispanics with limited English Proficiency or LEP.

with those who are bilingual or speak mostly/only English, we find that the ability to speak English plays a large role in Hispanics’ ability to succeed economically and educationally in Delaware. The DHNA found that the majority of Delaware Hispanics speak only or mostly Spanish. In fact, 446 (55.6%) reported that they speak little or no English, which means that many Delaware Hispanics may find language to be a significant barrier to achieving an economically stable life.

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The DHNA found that many non-English speaking Hispanics are interested in improving their social and economic situations. In fact, 85.5% of non-English speakers reported that they were interested in taking English classes and 86.8 percent have an interest in attending job training. Hispanics’ interest in learning English was also brought up in community leader interviews:

We have to facilitate learning English. This is not a culture that seeks to be isolated – these people want to fit in and language is the first step toward doing that. – Nonprofit leader If they learn English, it will decrease the amount that they are exploited by businesses as consumers and by businesses as employees. – Private sector leader [Hispanic] organizations...and other groups should get together to develop programs that will teach English to immigrants. – Public sector leader

While many Hispanics are interested in English classes and job training to improve their economic status, the DHNA reported that Hispanics with limited English proficiency (LEP) experience numerous barriers to seeking out such opportunities, such as:

• LEP Hispanics are more than twice as likely as English-speakers to earn less than $20,000 per year (62.6% versus 31.2%).10

• LEP Hispanics are significantly more likely to report that they do not earn enough money to support their families (60.7% versus 41.1%).

11

• They are more than twice as likely as English-speaking Hispanics to be without public or private health insurance (59.8% versus 28.0%).

12

• Over forty percent (40.6%) of LEP Hispanics report being unemployed, versus only a quarter of English-speaking Hispanics.

13

• Less than a third (29.6%) of LEP Hispanics report having legal residency status, versus 57.3 percent of English speakers.

14

• LEP Hispanics are less likely than English speakers to have a drivers’ license.

15

10 x2 = 78.02, p = 0.00, N = 802 11 x2 = 29.98, p = 0.00, N = 781 12 x2 = 79.92, p = 0.00, N = 796 13 x2 = 18.40, p = 0.00, N = 802 14 x2 = 28.43, p = 0.00, N = 451

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There are two possible explanations for the economic differences between Hispanics who speak only or mostly Spanish and their English-speaking counterparts. Although LEP Hispanics may have a significant interest in taking English courses and job training to improve their current status, their existing low socioeconomic status may be preventing them from pursuing such opportunities. Schneider, Martinez and Owens (2006) report that the amount of resources (money, transportation, etc.) that Hispanics have at home is a strong indicator to whether or not they will enroll in English classes. For instance, an English course or job training program that may be available and possibly affordable to a LEP Hispanic may still not be possible to attend because the immediate need to work and address the economic needs of his family prevents him from setting aside the time or money to enroll (an succeed) in such programs. This scenario where economic stability (work) is valued over education has been documented in academic studies on immigrant Latino populations (Bohon, McPhereson & Atiles, 2005), and was touched upon in DHNA interviews. As one educational leader stated:

There are plenty of programs available but some people are just too busy working to take time out to go to school.

Another possible explanation for such large differences in economic statuses may be due to non-English speakers’ difficulty in communicating with professionals within government institutions or their fear of being detained or deported due to their residency status. For example, an ESL course that is offered at the Delaware Technical and Community College, or a public school building may be available and affordable for an immigrant who wants to learn English to gain citizenship, but she may feel uncomfortable or even threatened to attend the classes within a public facility. Both scenarios pose a significant problem while also perpetuating a cycle of economic strife.

Inability to Access Information on the Internet as a Barrier Another barrier that LEP Hispanics may face when trying to improve their economic status is the inability to access information on the internet. Today, many Americans turn to the internet for economic purposes, such as finding a job, home, or courses that would provide economic opportunity, such as computer courses and job training. However, the DHNA found that only 3 percent of Hispanics report that they would go to the internet to find information on their family’s needs. The relationship between Hispanics and access to the internet has been examined in research, which has found that low English proficiency and low educational attainment both act as barriers to accessing the World Wide Web. For instance, in 2003 the U.S. Department of Commerce (2004) reported that only 32.7 percent of Hispanics ages 3 and older access the internet, versus 65.1 percent of whites. However, in Fox & Livingston’s (2007) survey of Latino adults ages 18 and older, which factored in English proficiency and educational attainment of Latinos, found that while 56 percent of Latino adults use the internet, only 32 percent of Spanish-dominant speakers and 31 percent of Latinos with less than a high-school diploma access the internet.

15 x2 = 162.06, p = 0.00, N = 802

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Transportation as an Economic Barrier While the language barrier is a significant barrier to economic advancement in the Hispanic community, the DHNA also identified transportation as a factor in Hispanics’ economic disparities. In fact, 47.3 percent of survey respondents indicated that they do not have a driver’s license. This is problematic when considering that a large portion of the state (primarily in Kent and Sussex Counties) is rural. When examining the types of transportation used by adult Hispanics who do not have a license, we find that the majority rely on friends and family for transportation (54.6%) and public transportation (28.6%), with smaller populations driving without a license (10.1%), walking (5.8%) and utilizing taxis (0.8%). Focus groups and interviews with community leaders emphasized the difficulties that the Hispanic community faces because of its low rates of licensed drivers:

There is no public transportation, which makes it tough for immigrants. – Focus Group Participant Because of the transportation problems, it forces people to drive without a license and then you can go to jail. – Focus Group Participant If you don’t have a license, you can’t drive and so you can’t work. – Focus Group Participant An issue that can easily be solved is providing driver’s licenses so that people can drive legally, obtain insurance and buy cars. It is a basic form of identification that contributes greatly to the safety of the entire society. I don’t see a downside to this and it has worked successfully in Maryland for four years. We should introduce the same program here. – Non-profit leader The biggest problem is… no identification. They cannot get driver’s licenses, insurance or loans. I think we need to issue driver’s licenses to Hispanic people so they can prove they are who they say they are. – Private Sector Leader

The economic disparities of Hispanics who do not have a license can be seen in some of the findings from the DHNA sample. For instance, Hispanics without a license are significantly more likely to report that they are unemployed.16

• speak only or mostly Spanish (79.3% versus 34.5%);

Also, these Hispanics are more than twice as likely as those with a license to:

17

• have a household income of less than $20,000 per year (68.9% versus 30.7%);

18

16 x2 = 22.8, p = 0.00, N = 802 17 x2 = 1.620E2, p = 0.00, N = 800 18 x2 = 1.163E2, p = 0.00, N = 802

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• not have a high school diploma (55.3% versus 23.9%).19 Large populations of Hispanic adults without drivers’ licenses may also be problematic for Hispanic youth. In fact, more than half (52.8%) of Hispanics who do not have a driver’s license have at least one child under the age of 18 living in the home, meaning that some Hispanics may find transportation as a barrier to accessing needed services for their children.

Conclusions on Economic Status Using data from the DHNA as well as literature from nonprofit and government sources demonstrates that many Hispanics in Delaware are experiencing economic hardships as indicated through high unemployment rates and high rates of low household incomes. Although many Delaware Hispanics indicate that they are interested in job training and English classes, the Consortium has found that there are numerous barriers that prevent Hispanics from economic opportunity. These barriers include poverty, high rates of limited English proficiency, and transportation problems. The DHNA suggests that there is a strong connection between economic status and English proficiency. Therefore, the Consortium believes that policy and program interventions that are designed to improve the economic status of Delaware Hispanics must include English language and literacy education. Given all of the barriers presented in the DHNA, the Consortium has proposed some activities that professionals in Delaware’s public and nonprofit sectors can undertake to improve Hispanics’ economic status may include20

• Job training initiatives that are designed to meet the cultural and linguistically needs of the Hispanic community.

:

• Job training initiatives that match growing industries in Delaware so that job training graduates can find success in the job market after program completion.

• An expansion of the eligibility requirements for unemployment insurance so that those who are undocumented can obtain resources needed to develop economic stability and citizenship.

• An expansion of DART services so that they Hispanic communities can have better access to the transportation they need.

19 x2 = 82.54, p = 0.00, N = 793 20 These recommendations are a part of a larger set of policy recommendations that can be found in chapter five. Some of these recommendations are similar to policy agendas set by other advocacy organizations, which are also listed in that chapter.

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CHAPTER 3: DELAWARE HISPANICS AND EDUCATION

What Does the Delaware Hispanic Needs Assessment (DHNA) Tell Us? Educational attainment plays a substantial role in an individual’s ability to succeed in life. However, the DHNA conducted by Bendixen & Associates (2008) demonstrated that a large number of Hispanics in Delaware do not finish high school and few finish college. For example, almost two-fifths (38.8%) of the DHNA survey sample indicated that they had less than a high school education. Given the importance that education may have on an individual’s ability to achieve economic stability, the Consortium wanted to expand its knowledge of key educational issues within the Hispanic community, including: 1.) How the educational status of Delaware Hispanics compares to other populations; 2.) the status of Hispanic individuals without a high school diploma; 3.) factors related to high educational attainment; and 4.) possible barriers to educational success within the Hispanic community. To learn more about these key education issues, the Consortium performed a further analysis on DHNA data and gathered information from government and nonprofit research. The following chapter presents findings from these efforts.

Key Issues Related to Education in the Hispanic Community

Hispanic Adults in Delaware and Education Similar to the DHNA21

Another problematic finding from the DHNA is that many Hispanic adults in Delaware do not attain a college or graduate degree. While the overall Delaware population is similar to the national average of adults with a college degree, Delaware Hispanics experience disparities in post-secondary education. For instance, when looking at Delawarean ages 25 and older, we find that in 2006, more than half (51.5%) had attended some college, and 33.8 percent had attained at least a two-year college degree (The U.S. Census (2008). However, for Hispanic adults in the same age group, only 23.8 percent had attended some college and 14.4 percent had attained a college degree. While Hispanic adults nationwide typically experience lower rates of college

, the U.S. Census (2008) reports that a large percentage of Delaware Hispanics do not finish high school, although the percentage of Delaware Hispanic adults without a high school diploma is only slightly higher than the percentage of Hispanics nationwide (see Table 3). However, when comparing educational attainment for Delaware Hispanics to the overall population of the state, we find significant educational disparities. For instance, while 44.1 percent of Delaware Hispanic adults over the age of 25 do not have a high school diploma, the statewide average for adults without a diploma is only 15.5 percent (see Table 3).

21 The U.S. Census and the DHNA report differences in the percentage of Hispanic adults without a high school diploma. However, this may be due to the fact that the U.S. Census sample only includes Hispanic adults ages 25 and older while the DHNA survey sample included Hispanic adults ages 18-24, which may account for some of the difference.

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attendance and graduation, Delaware Hispanics are fairing worse than those nationwide. In fact, for Hispanics nationwide, 32.1 percent had attended college with 17.5 percent having attained a degree. Although having a high school diploma can make a significant difference in one’s ability to succeed economically, in today’s economy many individuals without a college degree may find that they are not able to be competitive in the job market.

Table 3. A Comparison of Education Attainment of Adults Ages 25 and Older, All Races and Hispanics/Latinos, U.S. and Delaware

U.S. All Races

U.S. Hispanics

Delaware All Races

Delaware Hispanics

Less than 9th Grade 6.5% 23.9% 4.8% 31.8%

9th Grade – 12th Grade (No Diploma)

9.4% 15.9% 9.7% 12.3%

High School Diploma/GED 30.2% 28.1% 33.9% 31.1%

Some College 19.5% 14.6% 17.7% 9.4%

Associates Degree 7.4% 5.2% 6.9% 3.6%

Bachelor’s Degree 17.1% 8.4% 16.4% 7.9%

Graduate/Professional Degree 9.9% 3.9% 10.5% 2.9%

Note: Percentages may not add up to 100% due to rounding. Source: U.S. Census Bureau, 2006

The Status of Delaware Hispanics without a High School Diploma As with any racial group, the difference a high school diploma can make on one’s economic situation may be significant. Using DHNA data, it is interesting to examine the current status of Hispanics who do not have a high school diploma:

• Almost a quarter (23.9%) work in construction and over ten percent (10.6%) work as day laborers.

• More than half (54.1%) live in households that earn less than $20,000 per year.

• Eight in ten (83.4%) are interested in job training.

• Only a quarter (25.1%) have a bank account.

• They are significantly less likely to own their home (20.5% versus 42.1% of high school grads).22

• They are significantly less likely to have health insurance (43.1% versus 61.3%)

23

22 x2 = 39.17, p = 0.00, N = 787

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• They are more likely than high school graduates to report their quality of life as mediocre or poor (34.5% versus 26.4%).24

• More than three-fourths (77.5%) speak only or mostly Spanish.

• Men and women are equally as likely to report that they do not have a high school diploma.

• Those without a high school education are significantly less likely to be a U.S. citizen, or a legal resident/worker in Delaware.25

During the focus groups and interviews, community members and leaders emphasized the importance of education to the overall success of Hispanics in Delaware:

Higher education needs to be more attainable for kids; it needs to be made an accessible reality. – Focus group member There needs to be more training for Hispanics to learn a trade so they have more job and career development opportunities. – Focus group member When a person is educated, they know where to go. They should create education centers and publicize them for the Hispanic community. Once you have an education you have access to everything. - Focus group member If [Hispanics] learn English, it will decrease the amount that they are exploited by businesses as consumers and by businesses as employees. – Private sector leader

Given the economic status of Hispanics who do not have a high school diploma, the relationship between education and economic stability that was emphasized in chapter one is even further highlighted here. Although the above sections provide information on Hispanic adults in Delaware, research indicates that Hispanic youth in Delaware are also experiencing educational disparities that may result in economic barriers as they enter adulthood.

Hispanic Youth and Education Hispanic Youth and Educational Achievement. In 2007, the Delaware Department of Education reported that almost 13,000 students enrolled in Delaware’s Public Schools were Hispanic (see Table 4), with Kent and Sussex Counties having a larger proportion of Hispanic students compared to New Castle County. As the number of Hispanic students has increased

23 x2 = 24.85, p = 0.00, N = 789

24 x2 = 16.93, p = 0.00, N = 795 25 x2 = 33.74, p = 0.00, N = 617; x2 = 15.24, p = 0.00, N = 498

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over the last decade, we find that Hispanic students in Delaware public schools are still falling behind in achievement. One indicator of this can be seen in the achievement gap on the Delaware Student Testing Program (DSTP).

Table 4. Number of Hispanic Students in Delaware Public and Nonpublic Schools, 1997-1998 and 2007-2008 School Year Comparisons

2007 - 2008 School Year

1997-1998 School Year

No. of Hispanics

Percent No. of Hispanics

Percent % Increase in Hispanic Students 1997-8 to 2007-8

Delaware Public Schoolsa 12,881 11.8% 5,194 4.6% 59.7% New Castle County 8,534 6.0% 3701 5.6% 56.6% Kent County 1,723 11.4% 777 3.1% 54.9% Sussex 2,624 10.4% 716 3.4% 72.7% DE Nonpublic Schoolsb 801 3.0% - - N/A

Source: aDelaware Department of Education (2008b.) Source: bDelaware Department of Education (2008c.) In essence, the achievement gap is the disparity in testing scores between a particular student group and a reference group. Many times the achievement gap refers to the differences in scores between minority students and white students. When comparing DSTP scores of Hispanics to Whites, we find that there are large achievement gaps across testing subjects and across grade levels. For instance, in 2008, 80.1 percent of white students met or exceeded the DSTP reading standard, compared to only 56.2 percent of Hispanic students (Delaware Department of Education, 2008). Although the achievement gap varies across grade levels and testing years, Hispanic students continuously score lower than white students in Delaware. While race is often compared when considering the achievement gap, the Delaware Department of Education also provides data on the achievement gap related to other characteristics pertaining to Hispanic students. For instance, given the large number of Hispanic families who are low-income, achievement gap analysis demonstrates that along with race, low-income status is a factor in lower testing scores. For instance, in 2008, 89.2 percent of 10th graders who were not low-income met or exceeded the DSTP standard for reading, compared to only 71.9 percent of 10th graders who were low-income. Similarly, there is a considerable difference between students who are English proficient and those who are limited in English proficiency (LEP). In 2008, 81.3 percent of English-proficient 8th graders met or exceeded the DSTP reading standard, compared to only 55.9 percent of LEP 8th graders. Although these statistics are only from the DSTP reading scores, Delaware Department of Education data from 2002 to 2008 show that Hispanic, low-income, and LEP students consistently score lower than those who are white, not low-income and English proficient across grade levels and across testing topics, including math, writing, science, and social studies.

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Hispanic Youth and High School Drop Out. Along with the achievement gap, high school dropout has become a serious problem among Delaware Hispanic youth. The Delaware Department of Education reports that since 1988, Hispanics have had the highest dropout rates of all ethnic groups for all but one year, ranging from a low of 5.1 percent (1993) to a high of 14.2 percent (1989) (Greenwald, D’Souza & Yun, 2007). As of last year, the dropout rate for Hispanics was 8.5 percent. While in many cases dropout rates are an indicator of school performance, the Pew Hispanic Center warns that this may not be completely accurate for Hispanic communities (Fry, 2003). They state that since one of the contributing factors of the growing Hispanic community are the large numbers of immigrants, many children who are labeled as dropouts have never attended an American school. This finding indicates that while supporting Hispanic youth enrolled in school is an important factor in reducing dropout rates, significant effort should be made to engage immigrant youth in the educational system. Numerous studies have been dedicated to the topic of Hispanic school dropout, which provide some insight to why this particular racial group exhibits high dropout rates. For instance, Hernandez and Nesman (2004) identified several risk factors of Hispanic students who drop out, such as high absenteeism, high numbers of disciplinary measures, placement in special or alternative education classes, and eligibility for reduced or free lunch. Also, Fry (2003) has noted that Mexican immigrant youth are more likely than other Hispanic immigrants to drop out of school. One particularly interesting finding has been the relationship between immigrants’ previous experiences to education with dropping out. Fry’s (2003) study on Hispanic immigrants found that immigrants who were never engaged into the U.S. school system were up to three times as likely to not finish high school. Typically these immigrants are schooled in their country of origin, but never enter an American school. Kohler and Lazrin (2007) have also attributed higher dropout rates to Hispanics’ under-representation in pre-school programs, such as the Head Start Program. Hispanic Youth and English Language Learner (ELL) Programming. One reason that Hispanic students may not have the same achievement levels as other racial groups may be due to the large proportion of Hispanic students that are enrolled in English Language Learner (ELL) Programs. In fact, during the 2006-2007 school year, 43.5 percent of Hispanic public school students were enrolled in ELL programs, comprising more than 76.5 percent of total ELL enrollment (Delaware Department of Education, 2007). Although ELL grade-school programming has been designed to provide LEP students with the language skills needed to advance academically, research has demonstrated that the current methods of ELL instruction are not meeting the academic needs of foreign speaking students, especially in the case of Hispanics. Looking at statistics alone, we find that many states are having trouble meeting the English Language Proficiency targets that they set for their students. In fact, the U.S. Department of Education reports that during the 2005-2006 school year, 78.0

29

percent of ELL students in Delaware were reported to be making progress in English proficiency; however, only 4.6 percent were reported to be attaining English proficiency, making Delaware one of the 26 reporting states that are not meeting their English proficiency targets (U.S. Department of Education, 2008). Callahan, Wilkinson and Muller’s (2008) study of Mexican-origin linguistic minorities provides some insight on indicators of success in ELL classes. Their findings indicate that second and third generation students did better than first generation students. Also, students in schools with large concentrations of Latinos fared better than students in schools with low Latino enrollment. This latter finding is particularly relative to Latinos in Delaware, since the population of Latino students (especially in New Castle County) is still relatively small.

Barriers to Education

Language as a Barrier to Education Although it may be assumed that English language skills can predict educational success, the DHNA demonstrates that there is a relationship between Hispanics’ ability to speak English and educational attainment.26 For instance, 54.3 percent of LEP Hispanics in the DHNA27

Table 5. Educational Attainment of English and Limited English Proficient Hispanics with Limited English Proficiency (LEP) in Delaware, According to the DHNA.

reported that they have less than a high-school diploma, compared to 19.4 percent of English speakers. Table 5 provides a breakdown of educational attainment of English and LEP Hispanics, as found in the DHNA.

English Speaking Hispanics (N = 355)

Limited English Proficiency Hispanics

(N = 438) Less than High School 19.4% 54.3%

High School Diploma/GED 36.3% 31.3%

Some College/Technical School 29.6% 10.0%

Bachelor’s Degree 7.9% 3.7%

Graduate/Professional Degree 6.8% 0.7%

In order to increase English proficiency across the state, public and nonprofit initiatives have been implemented to provide English as a Second Language (ESL) courses. These classes are

26 x2 = 130.6, p = 0.00, N = 793 27 For the purposes of this report, Hispanic respondents in the DHNA who described themselves as speaking only or mostly Spanish are considered as Limited in English Proficiency (LEP).

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intended for adults who are limited in English proficiency (LEP). According to State of Delaware records, in FY2007, 1,524 individuals enrolled in ESL courses funded by the state. Of these foreign language speakers, 78 percent identified themselves as Hispanic or Latino. Given the barriers that LEP status may have on educational attainment and economic status, it is no surprise that 85.5% of LEP Hispanics reported that they are interested in taking English classes. However, data from the DHNA also suggests that Hispanics experience barriers to utilizing ESL courses. These barriers include economic constraints, lack of transportation, and low utilization rates of government sources, which were discussed in the preceding chapter on the economic status of Hispanics under the title, Language as an Economic Barrier.

Poverty as a Barrier to Education Along with LEP status, the Consortium has found that the economic status of many Delaware Hispanics may act as a barrier to attaining educational advancement. As stated earlier, more than half (54.2%) of Hispanics who do not have a high school diploma live in households with incomes of less than $20,000 per year. This is compared to Hispanics with higher household incomes, in which 22.8% are without a high school diploma. Low incomes may act as a barrier to education in several ways. For instance, low earnings may limit the amount of resources needed to attend or succeed in school, such as transportation, a computer, or even books. Another example may be that Hispanic adults with low household incomes may have to put more time and resources into employment in order to secure other needed resources, such as food and utilities. One specific key educational issue in the Hispanic community that was has been linked to poverty has been the high school drop out rate. For instance, 37.8 percent of DHNA survey respondents reported that they believe Hispanic youth drop out of school because they need to work.28

28 N=746

Hence, Hispanics’ lower economic status may explain why this ethnic group has the highest rates of dropout. This finding was also explored within focus groups and interviews conducted through the DHNA. Some specific comments included:

Some think that if they can work and earn money that is better than going to school. - Focus group participant [Hispanic youth] have nothing to look forward to and they can’t see the long term. They only see the paycheck now and they feel guilty that they are in school while the rest of the family is working and feel as though they also must bring in money for the family now. – Educational leader (Interview participant) Teenagers are often forced to work and they don’t have rights or access to the services they need. – Non-profit leader (Interview Participant)

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I think [Hispanic] parents want their kids to graduate [from high school] but there is a lot of pressure to go to work. I think we need to get creative about ways to keep the kids in school but that takes more money. - Private sector leader (Interview Participant)

Hispanic youth’s interest in dropping out of school to seek employment may also be fueled by their increased ability to find work without a high school diploma. Although the poverty status of Hispanic dropouts is similar to their White counterparts, 56 percent of Hispanic high school dropouts are more likely than Whites to hold jobs (56% versus 49%) (Fry, 2003).

Limited Parental Involvement as a Barrier to Educational Parental involvement is an important factor in children’s academic success. In order to improve the outcomes of their children’s academic careers, parents may provide them with educational enrichment prior to entering school and/or navigate the educational system so that it supports their children. However, for Hispanic parents who are not proficient in English and/or have not achieved academic success themselves, these may be difficult tasks. In the DHNA, 469 (58.6%) reported that they had children under the age of 18 living in the household. Out of this sub-population of Hispanic parents/guardians, 54.8 percent reported that they are not proficient in English and 37.5 percent29 do not have a high school diploma. Only 16.5 percent of those with children in the household also indicated that they have difficulty in communicating with their children’s teachers or school officials.30

29 N = 465 30 N = 455

While this statistic may seem low, the DHNA did not ask respondents if in fact they have tried to communicate with teachers and school officials. Hence, it is possible that some of the respondents who reported that they have no communication difficulties have not previously tried to communicate with educational staff and faculty. When discussing the issue of English proficiency and educational attainment, many interview and focus group participants reported that parental involvement is paramount to academic success and that there is an intergenerational factor in learning English and becoming academically successful. Overall, many believe that for Hispanic youth to achieve success in English proficiency and education, their parents must also make educational advancements. Without parents’ interest or effort in education, a cycle of illiteracy perpetuates across generations. Figure 3 provides a diagram description of this cycle. Some specific comments from focus groups and interviews demonstrating this cycle included:

Because sometimes the parents aren’t educated, there is no role model at home (for education). – Focus group participant

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Children do not see role models for

education through their parents.

Children learn to value work over

education.

Children do not achieve high educational attainment or

learn English.

Children grow up and raise children in environment that

emphasizes work over education.

Economic necessity results in Hispanic

parents emphasizing work over education.

Parents do not learn

English or achieve high educational attainment

We have to educate the parents so that they are more encouraging of their children. This is hard because they have to work and they really don’t see a lot of opportunities for higher education so they become disinterested. Outreach programs need to reinforce the value of education to both children and parents. – Non-profit leader I think it all comes back to education and I think the primary responsibility falls on the (Hispanic) parents. Above anything else they need to make an effort to learn the language – once they do that they can

communicate with teachers, the PTA, etc. – Health care leader Parents don’t speak English and cannot navigate the educational system for their children. – Educational leader

Lack of Support and Discrimination as Barriers to Education Finally, lack of support and discrimination within schools have been identified as other barriers to educational success, particularly for youth in Delaware. While the ability to communicate with Hispanic students and families is one factor in Hispanic youth’s school retention and academic success, it is not the only factor. For instance, in Bohon, MacPherson and Atiles’s (2005) study of Mexican migrant students in Georgia, school officials reported that having staff members who speak Spanish alone was not sufficient to serve migrant families and that there needs to be a better understanding of Mexican culture. Verbal communication is important, but many Hispanic students and their families may experience educational barriers due to issues of cultural competency31

31 For a definition of cultural competency, please refer to Box 5. What is cultural competency on page 45.

of educational professionals. For instance, Edl, Jones, and Estell’s (2008) found

Figure 3. The Influence of Socioeconomic Status on Educational Values in Hispanic Families: Intergenerational Effects

33

that fourth and fifth grade teachers perceived Latino students in ELL classrooms as having lower academic and interpersonal skills compared to white students and Latino students in mainstream classroom settings. Similarly, in a national survey of Latino parents, 47 percent stated that one of the reasons that Latino students do not do as well as white students is because “too many white teachers do not know how to deal with Latino kids because they come from different cultures” and 43 percent believed that “because of racial stereotypes, teachers and principals have lower expectations for Latino students” (Pew Hispanic Center & Kaiser Family Foundation, 2004, p.9). This issue was brought up during an interview with a public-sector leader:

There is a lack of engagement by the public schools – they are not connecting with the (Hispanic) students. Schools must provide these kids with guidance and they must show the kids the value of higher education. The schools must take the lead.

Discrimination in the educational setting does not have to be overt in order to inhibit Latino students’ academic success. In fact, even well-intentioned teachers and school staff may discriminate against Hispanic students because of a lack of understanding of Hispanic culture, behavior, and student needs. For instance, school guidance counselors who work with a small Hispanic student population may not be as knowledgeable on Hispanic-specific resources (i.e. scholarships, enrichment programs, etc.) that would help Hispanic students succeed. Also, teachers may misinterpret student behavior that is acceptable in Hispanic culture, but deemed unacceptable in non-Hispanic cultures. Robert Ricken and Michael Terc (2006) highlight this last point in their book, User-Friendly Schools for Latinos when they list several behaviors that Hispanic students are more likely to exhibit in the classroom which may be misinterpreted by school staff, such as:

• Hispanic students may limit their conversation with teachers and staff;

• Open praise towards Hispanic students may make them very uncomfortable due to some Hispanic cultures valuing cooperation over competition; and

• Hispanic students may avoid eye contact with figures of authority.

By becoming more culturally competent, not only would educational professionals be able to better serve Hispanic students and their families, but Hispanic families may be more capable and comfortable supporting educational staff in helping their children succeed.

Comparing Educational Attainment of Hispanic Adults Across County Lines When comparing Hispanics from New Castle County with those from Southern Delaware, we find that many educational trends resemble educational patterns for the overall population. For example, Hispanics living in New Castle County are significantly more likely to have a high school diploma (66.4% versus 51.7% in Southern Delaware).32

32 x2 = 16.4, p = 0.00, N = 795

However, high school drop out

34

rates for all racial groups is generally higher in New Castle County. Data from the DHNA did suggest, though, that the barriers that Hispanics experience when trying to achieve educational advancement may be different across the state. For instance, DHNA respondents in Southern Delaware were significantly more likely than those from New Castle County to believe that Hispanic youth drop out of school because they need to work, which suggests that poverty may be a greater barrier to education for Hispanics in Kent and Sussex Counties.33

Conclusions on Education

However, respondents from New Castle County are as likely as those from Southern Delaware to believe that Hispanic youth drop out of school because there is no support for them, which insinuates that discrimination and problems of cultural competency may be experienced by Hispanics across Delaware.

Using DHNA data as well as information reported by government and nonprofit sources, it becomes evident that Hispanics in Delaware experience many educational-related disparities, including a high proportion of the adult population not having a high school diploma, a low proportion attending and finishing college, and high drop out rates. Although many Hispanics indicate they would like to improve their English proficiency, the Consortium has identified several barriers that Delaware Hispanics may be experiencing in trying to improve their educational status. These barriers include: limited English proficiency, high rates of poverty, limited parental involvement with their children’s education, and lack of support and discrimination. Given the complexity of this issue, no single plan will be appropriate to addressing the educational needs of Delaware Hispanics. In fact, in order to improve English skills, retain Hispanic students, and increase high educational attainment within the community, there needs to be multi-focused educational strategies that will work towards: reducing poverty, engaging immigrants into the Delaware school system, creating school environments that are culturally and linguistically competent, increasing family literacy, and increasing parental involvement in their children’s education. Given all of the barriers presented in the DHNA, the Consortium has proposed some activities that professionals in Delaware’s public and nonprofit sectors can undertake to improve Hispanics’ educational status across the lifespan. They include34

:

• An expansion of ELL programming (also known as English as a Second Language (ESL) across the state.

• An increase in community-based, nonprofit organizations that collaborate and implement effective and efficient programs/projects that reduce the percentage of Hispanic who are limited in English proficiency.

33 x2 = 17.2, p = 0.00, N = 787 34 These recommendations are a part of a larger set of policy recommendations that can be found in chapter five. Some of these recommendations are similar to policy agendas set by other advocacy organizations, which are also listed in that chapter.

35

o Special attention should be given to efforts that target adults in households with children so that services will impact the whole family.

o Innovative programs that reach LEP adults need to consider timing, location, use of technology, and flexible methods of instruction.

• An expansion of opportunities for early childhood education for Hispanic children. Special attention should be given to early childhood education programs that include family literacy and engagement of adults in the household.

• An increase the number of teachers and school staff who are both linguistically and culturally competent in order to address the needs of Hispanic Delawareans. This includes:

o An increase in Delaware teachers who learn Spanish.

o An increase in Hispanic youth who enter the teaching profession.

o An increase in training for educational professionals in cultural competency

• An increase in dual-language approaches for educational programming (as opposed to the current English Language Learner system) across the state at all grade levels.

• An increase in funding for language education programs and projects.

• Initiatives that facilitate parental involvement in education. This includes family literacy programming, and programming that will assist Hispanic parents with becoming involved in their children’s schools and navigating their children’s education.

• An increase in community-based organizations that provide services to achieve educational policy objectives and support partnerships between Hispanic community-based organizations and schools.

• An increase in school and community-based efforts to develop mentoring programs that connect Hispanic college students and professionals with Hispanic students.

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CHAPTER 4: DELAWARE HISPANICS AND HEALTH

What Does the Delaware Hispanic Needs Assessment (DHNA) Tell Us? Through the previous sections it becomes apparent that the economy and education are two important issues facing today’s Hispanic population in Delaware. However, the DHNA conducted by Bendixen & Associates (2008) also identified health care as a serious issue in the Hispanic community. In fact, 16.9 percent35

The Health Status of Hispanics

of the DHNA survey respondents reported that health care was the most important issue for Hispanics in Delaware today. Health care has become a national concern for all racial groups in the United States. However, some of the findings from the DHNA raise questions about health in the Hispanic community, such as the large proportion of Hispanics who are without health insurance and the high rates of limited English proficiency (LEP). Given these concerns, the Consortium wanted to expand its knowledge of key health issues within the Hispanic community, including: 1.) the health status of Hispanics; 2.) the status of Hispanics who do not have health insurance; 2.) barriers to accessing health care. To learn more about these key health issues, the Consortium performed a further analysis on DHNA data and gathered information from government and nonprofit research. The following chapter presents findings from these efforts.

Similar to other minority groups, Hispanics experience many health disparities in relation to rates of morbidity, mortality, and risk factors for some diseases. Although there are some positive health trends in the Hispanic community, such as the fact that they are less likely than Whites to have heart disease, cancer, or die from a stroke (Office of Minority Health, 2008), there are still many key health issues within the Hispanic community that are concerning. For instance, when examining health data for the Hispanic community, we find that:

• According to the U.S. Center for Disease Control and Prevention, 23.1 percent of poor Hispanics rated their health as fair or poor, compared to only 8.5 percent of non-poor Hispanics (U.S. DHHS, 2008).

• Mexicans are twice as likely as Whites to be diagnosed with diabetes from a physician (DHHS, 2007).

• Hispanics are 1.6 times more likely to die from diabetes than non-Hispanics (DHHS, 2007).

• Hispanic women are 1.6 times more likely than Whites to suffer from cervical cancer (NCI, 2008).

35 N=738

37

• Compared to Whites, Hispanics are 11 percent more likely to be overweight or obese (DHHS, 2007).

• Hispanic males are almost three times more likely than white men to have HIV/AIDS. Hispanic women are five times more likely (Centers for Disease Control and Prevention, 2006).

• In the 2007 National Health Interview Survey, Hispanics were more likely than non-Hispanics to report that they experienced serious psychological distress in the past 30 days (National Center for Health Statistics, 2008).

• In regards to children, from 2001-2004, Mexican boys ages 6-11 were more likely than other races to be overweight (25.6%, versus 16.9% of whites and 17.2% of African Americans) (DHHS, 2007).

Generational Health Trends in the Hispanic Community So far, this discussion of health disparities has compared Hispanics with non-Hispanics. However, research also indicates that there are disparities across generations of Hispanics. When comparing first generation Hispanics (those who migrate to the U.S. from another country), second generation Hispanics (their children), and third generation Hispanics (their grandchildren), we find that the overall health of the population is declining over time. For instance, first generation Hispanics are healthier in relation to their instances of diabetes and heart disease, but later generations experience better overall health (see Table 6) (Taningco, 2007).

Table 6. Health Comparisons between First, Second, and Third Generation Hispanic Immigrants

Outcome Measure Healthier Group Mental Health Generations 1 & 2 Overall Health Generations 2 & Later

Overweight or Obese No Difference Diabetes Generation 1

High Blood Pressure Generation 1 Hearth Disease No Difference

Asthma Generations 1 & 2 Source: Taningco, 2007 Unfortunately, many of the health disparities experienced by Hispanics are related to preventable diseases. For instance, chronic liver disease was the 8th most common cause of death for Hispanics in 2007 (and coincidentally was not a leading cause of death for any other racial group studied) (U.S. DHHS, 2007). Considering that the leading cause of chronic liver disease is alcohol abuse (Riley & Bhatti, 2001), mental health services could be instrumental to reducing Hispanic’s risk of dying from the condition. However, according to the DHNA, more than two-thirds of Hispanic Delawareans are without access to mental health services.

38

Similarly, during the same year, perinatal diseases (diseases occurring around the time of birth) were the 10th most common cause of death for Hispanics (U.S. DHHS, 2007). However, in Delaware, Hispanic women are less likely than Whites and African Americans to receive prenatal care during the first trimester, a critical time in fetal development (Delaware Health Statistics Center, 2005). This disparity in prenatal care was found to be most significant in Sussex County.

Hispanic Health Issues across County Lines Interestingly, while the DHNA found that there were multiple differences found between Hispanics living in New Castle County and those in Southern Delaware when examining issues of economic stability and education, there were no differences found across county lines in terms of health. According to the DHNA survey, Hispanics across the state have the same likelihood of not having health insurance, access to mental health, and experiencing depression or anxiety.

Barriers to Health

Lack of Health Insurance as a Barrier to Health The topic of health care has become a national agenda as public costs for Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) have increased over the last several years. Despite increases in spending and coverage of government health care programs, large portions of the population still find that they cannot access health insurance or find affordable health care that meets their needs. This has been especially true in the case of the Hispanic population. In fact, according to data from the Census Bureau (DeNavas-Walt, Proctor & Smith, 2008), we find that in 2007 almost a third (32.1%) of Hispanics nationwide did not have access to any insurance. Also, only 40.3 percent of Hispanics were covered by employer-based insurance programs, compared to 65.6 percent of Whites. Although these rates of uninsured Hispanics are high, the DHNA suggests that a greater number of Delaware Hispanics lack health insurance. Some of the concerning facts from the DHNA include:

• More than 45 percent (45.7%) of respondents reported not having public or private health insurance.

• Just over a third (36.1%) reported having private insurance.

• Hispanics who are currently employed are no more likely to have health insurance than those who are unemployed.36

• Hispanics living in households earning less than $20,000 are significantly less likely to have any health insurance (41.7% versus 66.0%).

37

• Only 40.2 percent of LEP Hispanic report having health insurance, compared to 72.0 percent of Hispanics who speak English.

38

36 x2 = 0.95, p = 0.0.33, N = 798 37 x2 = 47.45, p = 0.000, N = 798 38 x2 = 79.92, p = 0.00, N = 796

39

• U.S. citizens are more likely than immigrants to report having health insurance (77.3% versus 36.3%).39

• Hispanics with a high school diploma are more likely than those who don’t to have health insurance (61.3% versus 43.1%).

40 Although the DHNA did not examine why Hispanics are uninsured, the U.S. Department of Health and Human Services reports (2008) that the three most cited reasons that Hispanics do not have health insurance are: their employer did not offer health insurance, cost, and loss of job. Given the expense of health care today, without insurance, Hispanics may not be able to get the health services they need. This issue was brought up during interviews with community leaders. For instance, one nonprofit leader stated:

Many Hispanic immigrants don’t have health insurance so they can’t get the treatment they need.

The relationship between access to health insurance and access to health care were also explored through the DHNA. For instance, we find that Delaware Hispanics who do not have public or private health insurance are five times as likely to report that they do not receive regular checkups from a doctor or nurse (27.6% versus 5.3%)41 and are 18 percent less likely to receive regular health screenings for chronic disease.42

Findings from the study also suggest that there is a relationship between having health insurance and perceived quality of life. In fact, 80.1% of Hispanics who have health insurance reported their quality of life as “good” or “excellent,” compared to only 65.5 percent of those without any insurance.

In other words, more than a quarter of uninsured Hispanics do not regularly see a medical professional for preventative care.

43

Limited Access to Needed Health Care Services as a Barrier to Health

Although not having health insurance is a significant barrier to receiving health care, the Pew Hispanic Center and Robert Wood Johnson Foundation report that large numbers of Hispanics do not have regular health care providers regardless of health insurance coverage, indicating that there are other barriers to consider in Hispanic health care (Livingston, Minushkin & Cohn, 2008). For instance, when comparing non-elderly adults who have health insurance, 53 percent of Hispanics report not having a regular doctor, compared to 44 percent of African Americans and 37 percent of Whites. 39 x2 = 65.17, p = 0.000, N = 609 40 x2 = 24.85, p = 0.000, N = 789 41 x2 = 74.43, p = 0.00, N = 791 42 x2 = 42.39, p = 0.00, N = 752 43 x2 = 21.82, p = 0.000, N = 798

40

Research on health care access demonstrates that Hispanics access many types of health care services at lower rates than other racial groups. For instance, according to the 2007 National Health Interview Survey (NHIS) (National Center for Health Statistics, 2008):

• Only 77.6 percent of Hispanics had a usual place that they went for medical care in 2007, versus 88.6 percent of Whites and 86.2 percent of African Americans.

• In the previous 12 months, only 52.2 percent of Hispanics reported having a flu shot, compared to 69.4 percent of Whites. Only 32 percent reported having a pneumococcal vaccination, versus 62.2 percent of Whites.

• Only 57.7 percent of Hispanics reported having excellent or very good health, compared to 69.6% of Whites.

Although these statistics refer mainly to the adult population, research also indicates that Hispanic children are lacking in preventative health care. In fact, from 2005-2006, 24 percent of Hispanic children under the age of 18 did not have a health care visit, compared to 13 percent of White children and 11.7 percent of African American children (DHHS, 2007). While lack of health insurance creates a barrier to accessing needed services, the DHNA suggests that there are several other barriers to receiving regular, preventative health care, such as:

Poverty

• Findings from the DHNA indicate that Delaware Hispanics living in households with annual household incomes of less than $20,000 are more likely than those living in higher household incomes to use the emergency room (33.5% versus 25.8%)44 or a clinic (35.4% versus 22.9%)45

• Hispanics in this income bracket are also twice as likely as those with higher household incomes to report that they have not had a checkup by a doctor or a nurse in the last five years

when a family member is sick (as opposed to having a regular doctor).

46 and are less likely to have access to mental health care.47

Education

• Hispanics who do not have a high school diploma are significantly less likely to report that they have had a regular checkup in the last five years (21.2% versus 12.2 % of high school graduates).48

44 x2 = 5.57, p = 0.018, N = 780 45 x2 = 14.91, p = 0.00, N = 780 46 x2 = 19.04, p = 0.000, N = 797 47 x2 = 38.5, p = 0.000, N = 738 48 x2 = 11.13, p = 0.01, N = 788

Data Source: Doty, 2003

41

Transportation

• Hispanics who do not have a driver’s license are 2.5 times less likely than those with licenses to report having a regular checkup in the last five years (9.0% versus 22.9%).49

English Proficiency

• Hispanics who are not English proficient are significantly more likely than English speakers to report not having a checkup in the last five years (22.3% versus 7.3%).50

• LEP Hispanics are also more likely to report that they do not receive regular health screenings for chronic diseases (42.6% versus 31.3%).

51

Similar to findings from the DHNA, a 2007 report on Hispanic health published by the Delaware Hispanic Cancer Coalition also demonstrated disparities in receiving health care services. The statewide survey had a sample that was similar to the DHNA survey and covered many health-related topics. Some of the findings from this study include:

• Uninsured Hispanics are less likely to receive a mammogram, PSA test (for prostate cancer), or colonoscopy compared to those with insurance.

• About 40 percent report that they do not have a person they could rely on to take them to medical appointments.

• Half of Hispanics rely on a clinic or emergency room for their regular medical care.

Language as a Barrier to Health Similar to findings related to economic status and education, the ability to speak English influences Hispanics’ ability to access proper health care services for their needs. As one private sector leader stated in a DHNA interview:

To address the health care problem in the short term there should be more bilingual health care providers from doctors to nurses to staff. In the long term, the federal government will have to address the insurance problem.

When comparing Hispanics surveyed through the DHNA with limited English proficiency (LEP) with those who do not have LEP status, we find that:

• LEP Hispanics are more than three times as likely to report having communication problems with health care providers (39.1% versus 11.6%).52

49 x2 = 29.02, p = 0.00, N = 795 50 x2 = 33.35, p = 0.00, N = 795 51 x2 = 10.01, p = 0.00, N = 758 52 x2 = 75.63, p = 0.00, N = 794

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• Hispanics who are not English proficient are significantly more likely than English speakers to report not having a checkup in the last five years (22.3% versus 7.3%).53

• LEP Hispanics are also more likely to report that they do not receive regular health screenings for chronic diseases (42.6% versus 31.3%).54

These findings are also similar to findings from the Delaware Hispanic Cancer Coalition Health Survey (2007), which reported that when asked what are the most important factors when receiving medical care and information, most Hispanics said that “Spanish language materials/brochures” (34%), followed by “professional Spanish speaking interpreters” (21%). Although LEP Hispanics are less likely to receive medical care, those who do receive care face communication problems. When looking at Hispanics as a whole, we find that there are differences in the ability to understand health care providers and instructions. For instance, according to the Commonwealth Fund (2001), only 45 percent of Hispanics report that it is easy to understand instructions given by their doctor’s office (versus 59% Whites); 64 percent say that it is easy to understand the directions on their prescription bottles (versus 79% Whites); and 16 percent of Hispanics say that they did not follow their doctor’s instructions because they did not understand them (versus 5% Whites). The same study also found differences between Hispanics who speak Spanish at home with those who speak English. For instance:

• Twenty-three percent of Spanish-speakers reported that the doctor listened some or only a little to them, versus 12 percent of English speakers.

• Twenty-five percent of Spanish-speakers said that they understood some or only a little of what their doctor said.

• Forty-three percent of Spanish-speakers reported one or more problems in communicating with their doctor, compared to 26 percent of English-speakers.

These disparities related to English proficiency have also been documented in academic research. In Derose and Baker’s (2000) study of emergency room patients who presented non-urgent medical issues, Hispanics with fair or poor English proficiency reported 22 percent fewer physician visits in the previous three months. Similarly, Fiscella, Franks, Doescher, and Saver (2002) found that Spanish-speaking Hispanics are significantly less likely than whites to have had a mental health visit or a flu vaccination in the previous year.

Title VI of The Civil Rights Act requires that health care providers offer language assistance (i.e. an interpreter) to those who are LEP. However, Ku and Flores (2005) point out that these services are not covered by insurance plans, meaning that while health care providers may offer the services, they may still be inaccessible to patients. This can lead to patients not understanding their health care provider or receiving translation by an inappropriate or incompetent interpreter (i.e. family member, untrained interpreter, etc.). In fact, according to the 2001 National Health Care Quality Survey, only 48 percent of individuals who needed an interpreter always or usually

53 x2 = 33.35, p = 0.00, N = 795 54 x2 = 10.01, p = 0.00, N = 758

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receives one and of those with an interpreter’s assistance, 70 percent reported that they were fully able to understand what the doctor was saying. This indicates that while there needs to be greater access to interpreter services in health care, increasing these services could greatly improve the level of care that Hispanics receive.

Discrimination as a Barrier to Health Although not explored in the DHNA, research also indicates that Hispanics experience discrimination in the health care industry. When examining results from the 2001 Health Care Quality Survey (Commonwealth Fund, 2001) it becomes apparent that Hispanics, along with African Americans and Asians, do not receive the same quality of care. Table 7 provides results from selected items of this survey.

Table 7. Disparities in Health Care Quality, Comparison of Race/Ethnicity (2001 Health Care Quality Survey)

Total White African American

Hispanic Asian

Percentage of respondents who have a physician of the same race/ethnicity

** 82% 23% 26% 39%

Percentage of adults who feel like they were treated with disrespect

11% 9% 16% 18% 13%

Percent who feel that they would receive better health care if they were of a different race or ethnicity

5% 1% 15% 13% 11%

Percentage of adults who were “very satisfied” with their health care in the past two years

62% 65% 61% 56% 45%

Percent of adults who are very confident that they will receive better care in the future

49% 52% 47% 40% 39%

Source: The Commonwealth Fund, 2001

Conclusions on Health Using DHNA data as well as information reported by government and nonprofit sources, it becomes evident that Hispanics in Delaware experience many health-related disparities, most notable elevated rates of disease. Although the DHNA, government, and nonprofit sources indicate that many of these disparities relate to preventable diseases, there are several barriers that have been identified to improving the health status within the Hispanic community. These barriers include: lack of health insurance, limited access to health care services, limited English proficiency, and discrimination in the health care industry. Findings from the DHNA also indicate that poverty, transportation, and limited English proficiency are also related to limited access of health care services. Similarly, the relationship between social and economic barriers

44

and health disparities has been highlighted in the Delaware Department of Health and Social Services 2006 report on cancer disparities:

Research reveals the impact of patient and system barriers on racial/ethnic cancer health disparities in the United States. Patient barriers, such as poverty, lack of health insurance, and lack of health literacy, affect the delivery of cancer prevention and treatment services received by minorities and the medically underserved. System barriers prevent cancer services from being provided as a continuum of care and create an inequality in the delivery of cancer care. As these barriers continue to contribute to cancer health disparities in the United States, health care delivery systems and Federal, State, and local agencies need to take the initiative to address these barriers and create equality in cancer care for racial/ethnic populations. (2006, p.2)

Given all of the barriers presented in the DHNA, the Consortium has proposed some activities that professionals in Delaware’s public and nonprofit sectors can undertake to improve Hispanics’ health status. They include55

:

• State officials should explore options to expand health coverage to the Hispanic community, particularly for those who are low-income and/or limited in English Proficiency. Such initiatives may include closing the Medicaid gap and expanding the Children’s Health Insurance Program (CHIP) to cover immigrant Hispanic children and pregnant Hispanic women regardless of immigrant status.

• An increase in community-based initiatives to increase access to preventative health services within the Hispanic community.

• Initiatives that increase the cultural and linguistic competency of health care providers in Delaware. This may include:

o partnerships between health care providers and Hispanic community-based groups;

o Spanish language education for health care professionals;

o Initiatives to recruit Hispanics (and culturally and linguistically competent non-Hispanics) into health care professions and health-related higher education programs; and/or

o Development of educational and support programs with materials translated in Spanish.

55 These recommendations are a part of a larger set of policy recommendations that can be found in chapter five. Some of these recommendations are similar to policy agendas set by other advocacy organizations, which are also listed in that chapter.

45

• Initiatives that increase patient access to well-qualified interpreter services in the health care industry.

• Programs in primary and secondary schools that engage Hispanic students into health service careers.

46

CHAPTER 5: POLICY RECOMMENDATIONS FOR THE DELAWARE HISPANIC COMMUNITY

This needs assessment, which is based on real data of Hispanics living in Delaware and nationwide, provides significant insight on the issues and challenges experienced within the Delaware Hispanic community. Although the Hispanic population in Delaware is currently small, it is a growing population that is adding to the diversity of the overall state. Given the current size of the Hispanic community, community and public service leaders across the state now have the opportunity to establish a social and economic environment that better supports the Hispanic community as it grows. This environment will not only benefit the Hispanic community by providing greater economic and educational opportunity, but it will benefit the overall state as more Hispanics are able to positively contribute to our economy and culture. Delaware Hispanic Needs Assessment (DHNA) suggests that although Hispanics in Delaware are interested in improving their economic and educational status, many are experiencing barriers to economic self-sufficiency and high educational attainment, and health. While specific barriers were highlighted throughout this report regarding each of the key issue areas (economic status, education, and health), there were some barriers that appear to be affecting all of these key issue areas, including high rates of limited English proficiency, poverty, and lack of transportation. Based on this needs assessment, several policy recommendations have been made so that government, education, and community-based organizations can better serve Delaware Hispanics of all ages. Many of these policy recommendations require that public, nonprofit, and for-profit organizations increase their cultural competency. This means that agencies need to learn more about Hispanic culture and how this culture relates to their practices and services. Box 2 provides more detail about what cultural competency is and how organizations can use it to guide practice. While increasing cultural competency is a broad recommendation for employers and service providers across the state, the Consortium has also made recommendations for the public and private sectors. By implementing these recommendations, Hispanics across the state will have greater opportunities for integration in society and will benefit more from Delaware institutions that provide employment, education, social services, and health-related services. Many of these are policy recommendations that are aligned with other policy agendas that have been set for improving the lives of Hispanics, children, and low-income families across the state, such as:

• The 2008 National Hispanic Leadership Policy Agenda (2008) • The National Center for Cultural Competence (2008) • The Rodel Foundation’s Vision 2015 (2006) • President’s Advisory Commission on Educational Excellence for Hispanic Americans

(2003) • The Henry J. Kaiser Family Foundation (2008)

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Policy Recommendations for Addressing Issues within the Hispanic Community

Economic Status • Support job training initiatives that are designed to meet the cultural and linguistically

needs of the Hispanic community.

• Match job training initiatives with growing industries in Delaware so that job training graduates can find success in the job market after program completion.

• Expand the eligibility requirements for unemployment insurance so that those who are undocumented can obtain resources needed to develop economic stability and citizenship.

• Expanding DART services so that they Hispanic communities can have better access to the transportation they need.

Education

English Language Learner (ELL) Adult Education

• Support the expansion of ELL programming (also known as English as a Second Language (ESL) across the state.

Box 2. What Is Cultural Competency? According to the National Center for Cultural Competence (NCCC) (www11.georgetown.edu, based on the work of Cross et al., 1989) cultural competence is an ongoing developmental process where organizations implement a conceptual model that embraces diversity. By implementing a culturally competent organizational model, agencies make a commitment to increase their cultural knowledge and integrate it into all aspects of organizational processes, policies, and services. More specifically, it requires that organizations:

• have a defined set of values and principles, and demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally.

• have the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge and (5) adapt to diversity and the cultural contexts of the communities they serve.

• incorporate the above in all aspects of policy making, administration, practice, service delivery and involve systematically consumers, key stakeholders and communities.

Cultural competence is a developmental process that evolves over an extended period. Both individuals and organizations are at various levels of awareness, knowledge and skills along the cultural competence continuum (NCCC, 2008, par. 4).

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• Support the capacity of community-based, nonprofit organizations to collaborate and implement effective and efficient programs/projects that reduce the percentage of Hispanic who are limited in English proficiency.

o Special attention should be given to efforts that target adults in households with children so that services will impact the whole family.

o Innovative programs that reach LEP adults need to consider timing, location, use of technology, and flexible methods of instruction.

Primary and Secondary Education

• Expand opportunities for early childhood education for Hispanic children. Special attention should be given to early childhood education programs that include family literacy and engagement of adults in the household.

• Increase the number of teachers and school staff who are both linguistically and culturally competent in order to address the needs of Hispanic Delawareans.

• Provide incentives for Delaware teachers to learn Spanish.

• Provide incentives for Hispanic youth to enter the teaching profession.

• Provide training to educational professionals in cultural competency

• Support the dual-language approaches for educational programming (as opposed to the current English Language Learner system) across the state at all grade levels.

• Increase funding for language education programs and projects.

• Support initiatives that facilitate parental involvement in education. This includes family literacy programming, and programming that will assist Hispanic parents with becoming involved in their children’s schools and navigating their children’s education.

• Support community-based organizations that provide services to achieve educational policy objectives and support partnerships between Hispanic community-based organizations and schools.

• Support school and community-based efforts to develop mentoring programs that connect Hispanic college students and professionals with Hispanic students.

Health • State officials should explore options to expand health coverage to the Hispanic

community, particularly for those who are low-income and/or limited in English Proficiency. Such initiatives may include closing the Medicaid gap and expanding the Children’s Health Insurance Program (CHIP) to cover immigrant Hispanic children and pregnant Hispanic women regardless of immigrant status.

• Support community-based initiatives to increase access to preventative health services within the Hispanic community.

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• Support initiatives that increase the cultural and linguistic competency of health care providers in Delaware. This may include the support or funding for:

o partnerships between health care providers and Hispanic community-based groups;

o Spanish language education for health care professionals;

o Initiatives to recruit Hispanics (and culturally and linguistically competent non-Hispanics) into health care professions and health-related higher education programs; and/or

o Development of educational and support programs with materials translated in Spanish.

• Explore and support initiatives that increase patient access to well-qualified interpreter services in the health care industry.

• Implement programs in primary and secondary schools that engage Hispanic students into health service careers.

Additional Research Efforts • More research is needed to understand issues of poverty, education, and health for on

Hispanic youth across the state.

• Given that many Hispanics indicated that “not having enough time” was a central reason for not utilizing opportunities for advancement, there should be a follow-up study on factors (such as timing, locations, teaching methods and others) that can improve the participation and outcomes of programs and services offered.

• Support for program evaluation of new and current community-based initiatives designed to meet the needs of Delaware Hispanics.

• Research findings need to be disseminated to all private and public organizations, as well as the general public, through a variety of mechanisms. The publication of papers and issue briefs on topics such as the economy and employment, health status, educational needs, and families will stimulate the use and future collection of Hispanic data.

• Collaborative relationships between the Consortium and community organizations that have the interests and expertise to support further research (such as the University of Delaware’s Center for Community Research and Service, the Governor’s Advisory Committee on Hispanic Affairs (GACHA), the Rodel Foundation, and others) should be developed.

Although many of these recommendations are broad, Delaware’s small size provides an opportunity for developing manageable programs that serve the Hispanic community and provide an example to other states. In addition, regularly scheduled assessments of Delaware’s Hispanic community are critical to guide program and policy development as well as to update goals. As with any exploratory study, such as the DHNA conducted by Bendixen & Associates, the

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information learned from study findings can be used to guide more specific and in-depth inquiries.

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APPENDIX A: METHODOLOGICAL SUGGESTIONS FOR FUTURE STATEWIDE SURVEYS OF DELAWARE HISPANICS

Demographic Data 1. Ask respondents what zip code they reside in so that Hispanic communities can be better

identified.

2. Use income categories that are similar to those used by the U.S. Census, so that survey data can be more easily compared to national data.

3. Make sure that income responses are mutually exclusive.

4. Include a question about marital status.

5. Ask respondent if he or she has a child and how many children the respondent has.

6. In addition to asking if the respondent has children living in the household, ask how many children live in the household.

7. Ask respondent how many individuals live in his or her household.

8. Ask respondents who are not citizens if they have tried to apply for citizenship/residency or ask if they are interested in applying.

9. Ask non-citizens what barriers they experience to citizenship.

10. Ask U.S. citizens how long they have been citizens.

Economic Data 1. Ask respondents if they work in Delaware or in another state.

2. Given that construction and day labor are two occupations that are closely related, ask respondents if they are a day laborer as a separate question from overall occupation (this will also allow an assessment if other industries in Delaware are utilizing day labor for their employee pool).

3. Asked unemployed respondents how long they have been unemployed.

4. Ask employed respondents how many hours they work each week, or their part-time/full-time status.

5. Along with asking respondents where they turn for information for their family’s needs, ask respondents what types of resources they try to access and where they access them from.

6. In addition to asking respondents if they feel as though they “currently earn enough to support you and your family,” ask respondent how often they go without specific necessities due to cost, such as food, medications, heat, etc.

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7. Ask respondents who do not have a driver’s license the extent to which lack of transportation creates barriers to employment, education, etc.

8. Ask parents who are not citizens if their children have legal status.

Educational Data 1. Ask respondents without a high school diploma why they dropped out of school.

2. Ask respondent questions about where he or she received an education, including how many years respondent attended school in country of origin and U.S.

3. Ask respondent if he or she has previously tried to communicate with an educational professional at his or her child’s school.

4. Ask respondents who are interested in taking English classes what factors would increase their chances of participation (i.e. hours, location, etc.).

5. Ask respondents with children to rate or describe their child’s experience in Delaware schools.

6. Ask respondents what factors would increase their participation in their child’s education.

7. Ask limited English proficient respondents if their children and/or other family members speak English.

Health Data 1. Ask respondent if he or she has a regular family doctor.

2. Ask respondents with children if their children have access to health insurance.

3. Ask uninsured respondents why the do not have health insurance.

4. Ask uninsured respondents how long they’ve been without health insurance.

5. Ask respondent if he or she uses an interpreter when accessing health care. Probe to find out whom usually provides interpretation (i.e. family member, professional, etc.).

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